The overall goal of this study is to understand how drug use and criminality are related to health disparities, particularly HIV, and service utilization among African American drug using and non-drug using women across criminal justice status. While drug use is similar across racial groups in the US, African Americans are disproportionately more likely to experience severe health consequences and criminal involvement as a result of drug misuse. Adequate health care may not be received by African American female offenders because they experience the burden of their race, class, gender, and criminal offender status. There is limited scientific data to help understand the linkages between health disparities such as HIV, untreated drug abuse, barriers to service utilization, and status as a criminal offender among African American females. This study is significant because of its potential to identify differences in health disparities and service utilization among African American drug using and non-drug using women in selected levels of criminal justice status (intensive correctional supervision-prison (n=200), moderate correctional supervision-jail (n=200), community supervision-probation (n=200), and no criminal justice involvement (n=200)). All 800 African American females will be followed longitudinally for three 6-month intervals to examine health status and the use of health services across time. The specific aims are: (1) To describe the prevalence of health problems among African American women across criminal justice status and drug use status; (2) To determine the cultural, predisposing, historical health, and potential enabling factors that are predictors of health problems among African American drug using and non-drug using women across criminal justice status over 18 months; (3) To describe the prevalence of untreated health problems, the patterns of health services utilization, and the cultural barriers to service utilization among African American women across criminal justice status and drug use status; and (4) To examine the factors that predict the likelihood of using health services among African American drug using and non-drug using women across criminal justice status over 18 months. The significance of this study includes the potential to provide criminal justice systems-level data for health planning and health policy for prevention, intervention, and treatment of African American female drug users. This study is significant to the public health field because of its potential to understand the severity of health disparities among African American women across criminal justice status and drug use status and to predict health status and the use of health services over time. This knowledge of African American females can be used as a foundation for future criminal justice systems-level interventions to increase the use of preventative health care and subsequently reduce the need for expensive medical services, as well as to decrease HIV risk behaviors including drug use, unprotected sex, and recidivism.